Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology
Background Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system. Aims To explore steroid-responsive catatonia with possible autoimmune origins. Method A retrospective investigation was conducted of clinical and paraclinical featur...
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Cambridge University Press
2025-09-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472425108065/type/journal_article |
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| author | Rifat Serav Ilhan Jonathan P. Rogers Kazım Cihan Can Berker Duman Burçin Çolak Meram Can Saka Seyda Erdoğan Rezzak Yilmaz Canan Yucesan Mine Araz Güle Çınar Sena Ünal Özlem Doğan Emine Uslu Thomas A. Pollak |
| author_facet | Rifat Serav Ilhan Jonathan P. Rogers Kazım Cihan Can Berker Duman Burçin Çolak Meram Can Saka Seyda Erdoğan Rezzak Yilmaz Canan Yucesan Mine Araz Güle Çınar Sena Ünal Özlem Doğan Emine Uslu Thomas A. Pollak |
| author_sort | Rifat Serav Ilhan |
| collection | DOAJ |
| description |
Background
Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system.
Aims
To explore steroid-responsive catatonia with possible autoimmune origins.
Method
A retrospective investigation was conducted of clinical and paraclinical features, including imagining, serum, and cerebrospinal fluid findings in ten patients presenting with subacute onset catatonia and treated with steroid pulse therapy between January 2022 and January 2024.
Results
A retrospective chart review identified ten patients (of a total of 56) with steroid-responsive subacute onset catatonia. Catatonia types varied. All patients were positive for delirium and psychotic symptoms. Imaging and cerebrospinal fluid results indicated non-specific signs of central nervous system inflammation. Intravenous 1 g methylprednisolone pulse therapy resulted in complete remission in all patients. Autoantibodies for limbic and paraneoplastic encephalitis were negative for all patients. None of the patients fulfilled the criteria for definite autoimmune encephalitis or autoantibody-negative probable autoimmune encephalitis.
Conclusions
Diagnosis of autoimmune catatonia is challenging without autoantibody markers, but steroid responsiveness, combined with clinical and paraclinical features, may suggest an autoimmune mechanism.
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| format | Article |
| id | doaj-art-4d00a76232fe4d85aa0f5426d00a681f |
| institution | Kabale University |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-4d00a76232fe4d85aa0f5426d00a681f2025-08-20T04:01:18ZengCambridge University PressBJPsych Open2056-47242025-09-011110.1192/bjo.2025.10806Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiologyRifat Serav Ilhan0https://orcid.org/0000-0003-4609-3751Jonathan P. Rogers1https://orcid.org/0000-0002-4671-5410Kazım Cihan Can2Berker Duman3Burçin Çolak4Meram Can Saka5Seyda Erdoğan6Rezzak Yilmaz7Canan Yucesan8Mine Araz9Güle Çınar10Sena Ünal11Özlem Doğan12Emine Uslu13Thomas A. Pollak14https://orcid.org/0000-0002-6171-0810Department of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDivision of Psychiatry, University College London, London, UKDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Psychiatry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Neurology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Neurology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Neurology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Nuclear Medicine, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Clinical Microbiology and Infectious Diseases, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Radiology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Medical Biochemistry, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Rheumatology, Ankara University Faculty of Medicine, Ankara, TurkeySection of Neuropsychiatry, Department of Psychosis Studies, King’s College London, London, UK Background Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system. Aims To explore steroid-responsive catatonia with possible autoimmune origins. Method A retrospective investigation was conducted of clinical and paraclinical features, including imagining, serum, and cerebrospinal fluid findings in ten patients presenting with subacute onset catatonia and treated with steroid pulse therapy between January 2022 and January 2024. Results A retrospective chart review identified ten patients (of a total of 56) with steroid-responsive subacute onset catatonia. Catatonia types varied. All patients were positive for delirium and psychotic symptoms. Imaging and cerebrospinal fluid results indicated non-specific signs of central nervous system inflammation. Intravenous 1 g methylprednisolone pulse therapy resulted in complete remission in all patients. Autoantibodies for limbic and paraneoplastic encephalitis were negative for all patients. None of the patients fulfilled the criteria for definite autoimmune encephalitis or autoantibody-negative probable autoimmune encephalitis. Conclusions Diagnosis of autoimmune catatonia is challenging without autoantibody markers, but steroid responsiveness, combined with clinical and paraclinical features, may suggest an autoimmune mechanism. https://www.cambridge.org/core/product/identifier/S2056472425108065/type/journal_articleCatatoniaautoimmune encephalitisautoimmune psychosis |
| spellingShingle | Rifat Serav Ilhan Jonathan P. Rogers Kazım Cihan Can Berker Duman Burçin Çolak Meram Can Saka Seyda Erdoğan Rezzak Yilmaz Canan Yucesan Mine Araz Güle Çınar Sena Ünal Özlem Doğan Emine Uslu Thomas A. Pollak Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology BJPsych Open Catatonia autoimmune encephalitis autoimmune psychosis |
| title | Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology |
| title_full | Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology |
| title_fullStr | Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology |
| title_full_unstemmed | Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology |
| title_short | Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology |
| title_sort | retrospective chart review of cases of steroid responsive catatonia exploring a potential autoimmune aetiology |
| topic | Catatonia autoimmune encephalitis autoimmune psychosis |
| url | https://www.cambridge.org/core/product/identifier/S2056472425108065/type/journal_article |
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